• 제목/요약/키워드: Biomechanical technique

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전 십자 인대 재건술에서 대퇴골측 고정 방법의 초기 안정성의 비교 (Comparison of Primary Stability of Different Femoral Fixation Techniques in Anterior Cruciate Ligament Reconstruction)

  • 송은규;이근배;이문
    • 대한관절경학회지
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    • 제2권1호
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    • pp.85-92
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    • 1998
  • Various methods for fixation of graft have been widely used for reconstruction of anterior cruciate ligament. However, the biomechanical strength of each fixation techniques are not fully understood. The purpose of this study is to compare the pull out strength of different fixation techniques which is probably the most important factor for the success at the initial stage of healing. Biomechanical test was carried out to measure and compare the pull out tensile strength of five different fixation techniques in 35 pig(Yorkshire) knees. ANOVA and Duncan multiple comparison test was applied for statistical analysis. In the two fixation techniques with bone patellar tendon bone graft, the mean maximum tensile strength was $1333.4{\pm}148.5N$ with titanium interference screw, while it was $1310.1{\pm}168.9N$ with biodegradable interference screw. The failure mode were pulled out of bone plugs from the femoral tunnel in majority cases. In the fixations with hamstring tendon, the mean maximum tensile strength were $1405.9{\pm}135.1N$ with SemiFix screw, $820.3{\pm}104.5N$ with biodegradable interference screw, and $682.1{\pm}54.2N$ with Endobutton. The mode of failure was variable in each technique. The tendon was pulled out from the tunnel in biodegradable interference screw fixation, the screw was bent in the SemiFix system, and the polyester tape were ruptured or the buttons were pulled into tunnel in Endobutton fixation. The mean maximum tensile strength of two interference screws with bone patellar tendon bone was statistically comparable to that of SemiFix with hamstring tendon. However biodegradable interference screw and Endobutton with hamstring tendon showed weaker maximum tensile strength than above three fixation techniques (P<0.05).

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Comparison of Compressive Forces on Low Back(L5/S1) for One-hand Lifting and Two-hands Lifting Activity

  • Kim, Hong-Ki
    • 대한인간공학회지
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    • 제30권5호
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    • pp.597-603
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    • 2011
  • Objective: The objective of this study was to compare one-hand and two-hands lifting activity in terms of biomechanical stress for the range of lifting heights from 10cm above floor level to knuckle height. Background: Even though two-hands lifting activity of manual materials handling tasks are prevalent at the industrial site, many manual materials handling tasks which require the worker to perform one-hand lifting are also very common at the industrial site and forestry and farming. Method: Eight male subjects were asked to perform lifting tasks using both a one-handed as well as a two-handed lifting technique. Trunk muscle electromyographic activity was recorded while the subjects performed the lifting tasks. This information was used as input to an EMG-assisted free-dynamic biomechanical model that predicted spinal loading in three dimensions. Results: It was shown that for the left-hand lifting tasks, the values of moment, lateral shear force, A-P shear force, and compressive force were increased by the average 43%, as the workload was increased twice from 7.5kg to 15.0kg. For the right-hand lifting task, these were increased by the average 34%. For the two-hands lifting tasks, these were increased by the average 25%. The lateral shear forces at L5/S1 of one-hand lifting tasks, notwithstanding the half of the workload of two-hands lifting tasks, were very high in the 300~317% of the one of two-hands lifting tasks. The moments at L5/S1 of one-hand lifting tasks were 126~166% of the one of two-hands lifting tasks. Conclusion: It is concluded that the effect of workload for one-hand lifting is greater than two-hands lifting. It can also be concluded that asymmetrical effect of one-hand lifting is much greater than workload effect. Application: The results of this study can be used to provide guidelines of recommended safe weights for tasks involved in one-hand lifting activity.

Biomechanical comparison of bone staple techniques for stabilizing tibial tuberosity fractures

  • Kyu-Tae Park;Min-Yeong Lee;Hwi-Yool Kim
    • 대한수의학회지
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    • 제63권3호
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    • pp.24.1-24.6
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    • 2023
  • This study compared the biomechanical properties of bone-stapling techniques with those of other fixation methods used for stabilizing tibial tuberosity fractures using 3-dimensionally (3D)-printed canine bone models. Twenty-eight 3D-printed bone models made from computed tomography scan files were used. Tibial tuberosity fractures were simulated using osteotomy. All samples were divided into 4 groups. Group 1 was stabilized with a pin and tension-band wire; group 2, with a pin and an 8 mm-wide bone staple; group 3, with 2 horizontally aligned pins and an 8 mm-wide bone staple; and group 4 with a 10 mm-wide bone staple. Tensile force was applied with vertical distraction until failure occurred. The load and displacement were recorded during the tests. The groups were compared based on the load required to cause displacements of 1, 2, and 3 mm. The maximum failure loads and modes were recorded. The loads at all displacements in group 4 were greater than those in groups 1, 2, and 3. The loads at 1, 2, and 3 mm displacements were similar in groups 1 and 3. There was no significant difference between groups 1 and 3. Groups 1 and 4 provided greater maximum failure loads than groups 2 and 3. Failure occurred because of tearing of the nylon rope, tibial fracture, wire breakage, pin bending, and fracture around the bone staple insertion. In conclusion, these results demonstrate that the bone-stapling technique is an acceptable alternative to tension-band wire fixation for the stabilization of tibial tuberosity fractures in canine bone models.

C7 Posterior Fixation Using Intralaminar Screws : Early Clinical and Radiographic Outcome

  • Jang, Sang-Hoon;Hong, Jae-Taek;Kim, Il-Sup;Yeo, In-Sung;Son, Byung-Chul;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • 제48권2호
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    • pp.129-133
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    • 2010
  • Objective : The use of segmental instrumentation technique using pedicle screw has been increasingly popular in recent years owing to its biomechanical stability. Recently, intralaminar screws have been used as a potentially safer alternative to traditional fusion constructs involving fixation of C2 and the cervicothoracic junction including C7. However, to date, there have been few clinical series of C7 laminar screw fixation in the literature. Thus, the purpose of this study is to report our clinical experiences using C7 laminar screw and the early clinical outcome of this rather new fixation technique. Methods : Thirteen patients underwent C7 intralaminar fixation to treat lesions from trauma or degenerative disease. Seventeen intralaminar screws were placed at C7. The patients were assessed both clinically and radiographically with postoperative computed tomographic scans. Results : There was no violation of the screw into the spinal canal during the procedure and no neurological worsening or vascular injury from screw placement. The mean clinical and radiographic follow up was about 19 months, at which time there were no cases of screw pull-out, screw fracture or non-union. Complications included two cases of dorsal breech of intralaminar screw and one case of postoperative infection. Conclusion : Intralaminar screws can be potentially safe alternative technique for C7 fixation. Even though this technique cannot be used in the cases of C7 laminar fracture, large margin of safety and the ease of screw placement create a niche for this technique in the armamentarium of spine surgeons.

A Case of Pedicle Screw Loosening Treated by Modified Transpedicular Screw Augmentation with Polymethylmethacrylate

  • Kang, Suk-Hyung;Kim, Kyoung-Tae;Park, Seung-Won;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • 제49권1호
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    • pp.75-78
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    • 2011
  • We report a case of pedicle screw loosening treated by modified transpedicular screw augmentation technique using polymethylmethacrylate(PMMA), which used the anchoring effect of hardened PMMA. A 56-year-old man who had an L3/4/5 fusion operation 3 years ago complained of continuous low back pain after this operation. The computerized tomography showed a radiolucent halo around the pedicle screw at L5. We augmented the L5 pedicle screw with modified pedicle screw augmentation technique using PMMA and performed an L3/4/5 pedicle screw fixation without hook or operation field extension. This modified technique is a kind of transpedicular stiffness augmentation using PMMA for the dead space around the loosed screw. After filling the dead space with 1-2 cc of PMMA, we inserted a small screw. Once the PMMA hardened, we removed the small screw and inserted a thicker screw along the existing screw threading to improve the pedicle screws' pullout strength. At 10 months' follow-up, x-ray showed strong fusion of L3/4/5. The visual analogue scale (VAS) of his back pain was improved from 9 to 5. This modified transpedicular screw augmentation with PMMA using anchoring effect is a Simple and effective surgical technique for pedicle screw loosening. However, clinical analyses of long-term follow-up and biomechanical studies are needed.

Biomechanical Comparison of Soft Tissue Reconstructions in the Treatment of Medial Patellar Luxation in Dogs

  • Kim, Sang-Yeoun;Moon, Hee-Sup;Park, Sung-Guon;Hong, Sung-Jin;Choi, Hee-Bok;Hwang, Tae-Sung;Lee, Hee-Chun;Hwang, Yong-Hyun;Lee, Jae-Hoon
    • 한국임상수의학회지
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    • 제34권6호
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    • pp.414-419
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    • 2017
  • The present study aimed to document the biomechanical findings of soft tissue reconstruction surgeries for the treatment of medial patellar luxation in dogs. Stifle joints (n = 12) from dogs weighing 4.1-8.4 kg were used in this study. The following soft tissue reconstruction techniques used for the treatment of medial patellar luxation were selected for this study: vastus medialis release, medial retinacular release, and capsule release for medial realignment (n = 6), and retinacular imbrication and anti-rotational suture for lateral realignment (n = 6). A 5-kg traction using an electronic scale was applied at $45^{\circ}C$ laterally for medial realignment and medially for lateral realignment. Fluoroscopic imaging was used to measure the length of patellar displacement (LPD) in each technique. Among medial realignment techniques, capsule release had the highest horizontal LPD; vastus medialis release had significantly higher horizontal LPD than medial retinacular release. Vastus medialis release had the smallest increase statistically in vertical LPD, and vertical LPD did not differ significantly between medial retinacular and capsule release. Among lateral realignment techniques, the horizontal LPD was significantly higher in anti-rotational suture with retinacular imbrication than in retinacular imbrication alone, but the vertical LPD did not differ significantly between the two groups. Our findings indicated that vastus medialis release could decrease the medial tension on the patella without inducing patellar instability in dogs. Both medial retinacular and capsule release could increase patellar instability; moreover, medial retinacular release does not decrease the medial tension on the patella. Antirotational suture with retinacular imbrication provides more lateral tension than retinacular imbrication alone.

극돌기 절골술과 추궁판 절제술에 대한 생역학적 비교 (The Comparison of Biomechanical Changes between Spinous Process Osteotomy and Conventional Laminectomy)

  • 강경탁;손주현;전흥재;김호중
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2008년도 추계학술대회A
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    • pp.1651-1654
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    • 2008
  • Previous reports have introduced the technique of spinous process osteotomy to decompress spinal stenosis, a procedure which aims to afford excellent visualization while minimizing destruction of tissures not directly involved in the pathologic process. However, bio-mechanically it has not been investigated whether the sacrifice of posterior spinous process might have potential risk of spinal instability or not, even though supra-spinous and inter-spinous ligament are preserved. Therefore the aim of this study is to evaluate the bio-mechanical properties after spinous process osteotomiy, using finite element analysis. In the model of spinous process osteotomy the increase of stress in the disc and segmental rangesof motions were not changed significantly. It is due to the fact that the instability of lumbar spine has been maintained by the two-types of ligaments compared with the prior surgical technique. Therefore, according to the finite element result on this study, these osotetomy was considered to be a clinicallysafe surgical procedure and could not cause the instability of patient.

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All-Inside 반월연골판 봉합술 (All-Inside Meniscal Repair)

  • 최남홍;김병연
    • 대한정형외과스포츠의학회지
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    • 제12권1호
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    • pp.8-15
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    • 2013
  • 과거 반월연골판 파열의 치료로 절제술이 시행되었으나 절제술 후에 슬관절의 퇴행성 변화가 진행되어 골관절염이 발생한다는 보고와 함께, 반월연골판의 생역학적 기능이 밝혀지면서, 가능한 한 반월연골판을 보존하기 위해 적응증이 되는 경우 봉합술의 시행이 증가되고 있다. 반월연골판 봉합술의 방법으로 outside-in, inside-out, all-inside 방법 등이 시행되고 있으며, 상기 방법들 중 all-inside 봉합 방법의 적응증, 수술 방법 및 수술 결과에 대해 알아보고자 한다.

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고유수용성신경근촉진법 골반패턴의 생역학적 분석 (Biomechanical Analysis of Pelvic Pattern in Proprioceptive Neuromuscular Facilitation)

  • 배성수;정현애;최재원;황보 각
    • The Journal of Korean Physical Therapy
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    • 제11권1호
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    • pp.137-141
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    • 1999
  • Proprioceptive neuromuscular facilitation(PNF), pelvic patterns are very important for orthopaedic and neurologic patient. It is an essential treatment techniques for motor developmental disorder. CVA, lumbar disk, muscle weekness and pain control of lumbar, pelvic and lower extremity, Pelvic patterns of PNP has 4 different type of basic pattern. each of them is combinding of movement plane and functional movement. Biomechanically most of PNF patterns are a concentric contraction with third-class lever. But the movement pattern have a technique of combination of isotonic that should make a eccentric contraction with second-class lever.

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고유수용성 신경근 촉진법 중 등장성수축결합의 생역학적 해석 (Biomechanical Analysis of Combination of Isotonic in Proprioceptive Neuromuscular Facilitation)

  • 배성수
    • The Journal of Korean Physical Therapy
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    • 제14권4호
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    • pp.260-265
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    • 2002
  • There are many methods for muscle strengthening. Muscle strengthening with eccentric contraction work is the best way by researcher's report. Also, eccentric contraction need proper resistance for muscle strengthening. Combination of isotonic in PNF is a muscle strengthening method with manual resistance. It makes concentric contraction $\rightarrow$ eccentric contraction $\rightarrow$ concentric contraction with continually and without muscle relaxation. Combination isotonic technique use with PNF pattern. Therefore, it will make development and increasing of active control motion, coordination, actual range of motion, strengthen and functional training in eccentric control of movement. Concentric contraction have the 3rd lever system and eccentric contraction have the 2nd lever system with combination of isotonic. Serial concentric contraction $\rightarrow$ eccentric contraction $\rightarrow$ concentric contraction make strong SEC and PEC. It will be increase elasticity of SEC, PEC and contractile components either.

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